The relationship between the volume of antimicrobial consumption in human communities and the frequency of resistance. Austin, D. J., Kristinsson, K. G., & Anderson, R. M. Proceedings of the National Academy of Sciences of the United States of America, 96(3):1152–1156, February, 1999. Place: United States
doi  abstract   bibtex   
The threat to human health posed by antibiotic resistance is of growing concern. Many commensal and pathogenic organisms have developed resistance to well established and newer antibiotics. The major selection pressure driving changes in the frequency of antibiotic resistance is the volume of drug use. However, establishing a quantitative relationship between the frequency of resistance and volume of drug use has proved difficult. Using population genetic methods and epidemiological observations, we report an analysis of the influence of the selective pressure imposed by the volume of drug use on temporal changes in resistance. Analytical expressions are derived to delineate key relationships between resistance and drug consumption. The analyses indicate that the time scale for emergence of resistance under a constant selective pressure is typically much shorter than the decay time after cessation or decline in the volume of drug use and that significant reductions in resistance require equally significant reductions in drug consumption. These results highlight the need for early intervention once resistance is detected.
@article{austin_relationship_1999,
	title = {The relationship between the volume of antimicrobial consumption in human communities and the frequency of resistance.},
	volume = {96},
	issn = {0027-8424 1091-6490},
	doi = {10.1073/pnas.96.3.1152},
	abstract = {The threat to human health posed by antibiotic resistance is of growing concern. Many commensal and pathogenic organisms have developed resistance to well  established and newer antibiotics. The major selection pressure driving changes  in the frequency of antibiotic resistance is the volume of drug use. However,  establishing a quantitative relationship between the frequency of resistance and  volume of drug use has proved difficult. Using population genetic methods and  epidemiological observations, we report an analysis of the influence of the  selective pressure imposed by the volume of drug use on temporal changes in  resistance. Analytical expressions are derived to delineate key relationships  between resistance and drug consumption. The analyses indicate that the time  scale for emergence of resistance under a constant selective pressure is  typically much shorter than the decay time after cessation or decline in the  volume of drug use and that significant reductions in resistance require equally  significant reductions in drug consumption. These results highlight the need for  early intervention once resistance is detected.},
	language = {eng},
	number = {3},
	journal = {Proceedings of the National Academy of Sciences of the United States of America},
	author = {Austin, D. J. and Kristinsson, K. G. and Anderson, R. M.},
	month = feb,
	year = {1999},
	pmid = {9927709},
	pmcid = {PMC15366},
	note = {Place: United States},
	keywords = {*Drug Resistance, Microbial/genetics, Anti-Bacterial Agents/*therapeutic use, Bacteria/*drug effects/*genetics/growth \& development, Bacterial Infections/*transmission, Cross Infection/transmission, Genes, Bacterial, Genetics, Population, Humans, Models, Biological, Models, Statistical},
	pages = {1152--1156},
}

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